Lund Lasse Wegener, Winther Jeanette Falck, Cederkvist Luise, Rechnitzer Catherine, Dalton Susanne Oksbjerg, Appel Charlotte Weiling, Schmiegelow Kjeld, Johansen Christoffer
Danish Cancer Society Research Center, Survivorship, Copenhagen, Denmark.
Paediatric and Adolescent Medicine, Juliane Marie Centre, University Hospital Rigshospitalet, Pediatric Clinics, Copenhagen, Denmark.
JNCI Cancer Spectr. 2020 Jun 13;4(5):pkaa046. doi: 10.1093/jncics/pkaa046. eCollection 2020 Oct.
Siblings of children with cancer experience severe stress early in life. Most studies of mental health problems in these siblings are limited by being small, cross-sectional, or self-reporting. In a population-based cohort study, we investigated the risk for antidepressant use by linking several nationwide, population-based registries comparing 6644 siblings of children diagnosed with cancer from 1991-2009 with 128 436 population-based sibling comparisons using the Cox proportional hazards model. Irrespective of cancer type, no increased risk of antidepressant use in siblings of children with cancer was found (hazard ratio = 1.00, 95% confidence interval = 0.91 to 1.11). However, data suggested that siblings being young at cancer diagnosis had an increased risk (2-sided = .01). Interaction analyses showed no modifying effect of parental socioeconomic position or antidepressant use. Findings from this study with a very low risk of bias are reassuring and important for families facing childhood cancer and for clinicians counseling these families.
患癌儿童的兄弟姐妹在早年经历着巨大压力。对这些兄弟姐妹心理健康问题的大多数研究存在局限性，如样本量小、采用横断面研究方法或自我报告形式。在一项基于人群的队列研究中，我们通过关联几个全国性的、基于人群的登记处，运用Cox比例风险模型，将1991年至2009年期间被诊断患有癌症的儿童的6644名兄弟姐妹与128436名基于人群的兄弟姐妹对照进行比较，调查了使用抗抑郁药的风险。无论癌症类型如何，未发现患癌儿童的兄弟姐妹使用抗抑郁药的风险增加（风险比=1.00，95%置信区间=0.91至1.11）。然而，数据表明，在癌症诊断时年龄较小的兄弟姐妹风险增加（双侧P=.01）。交互分析显示，父母的社会经济地位或抗抑郁药的使用没有调节作用。这项偏差风险极低的研究结果令人安心，对面临儿童癌症的家庭以及为这些家庭提供咨询的临床医生而言意义重大。
